NPIMap

Individual provider Active NPI

Bernard A. Stupski, D.O.

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1750571238
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60178352 Issued in WA
Practice address
14508 NE 20TH Ave Ste 102
Vancouver, WA 98686-6434
Phone
(360) 852-9070
Fax
(360) 397-2503
NPI assigned
Jul 31, 2007
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60178352 WA Primary

Addresses

Primary practice location

14508 NE 20TH Ave Ste 102
Vancouver, WA 98686-6434

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 1

IdentifierTypeStateIssuer
2009451MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101102000319 WA Practitioner - Family Practice 2163616368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

118 S Pkwy Ave
Battle Ground, WA 98604-9215
Phone (360) 342-8060

14508 NE 20TH Ave
Suite 102
Vancouver, WA 98686-6434
Phone (360) 852-9070

6100 NE 4TH Plain Blvd
Vancouver, WA 98661-6830
Phone (360) 947-2550

7410 Delaware LN
Vancouver, WA 98664-1408
Phone (360) 566-4402

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Oct 4, 2010 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Oct 4, 2010 Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients

Locations

14508 NE 20th Ave
Ste 102
Vancouver, WA 98686
Phone (360) 852-9070

7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402

Interoperability endpoints

  • Direct secure messaging: bstupski450878@direct.multicare.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1750571238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE STE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866434",
            "telephone_number": "360-852-9070",
            "fax_number": "360-397-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUPSKI",
        "first_name": "BERNARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-31",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60178352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009451",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.